How Neuroendocrine Tumors May Impact You
Content
Neuroendocrine tumors may release hormones that can cause a range of problems with your digestive system, from common stomach issues like cramping and diarrhea to stomach ulcers. If a tumor forms in your abdomen, it could cause painful blockages in your intestine. People with neuroendocrine tumors often see changes in skin tone, like a rash or flushed face, and can experience trouble breathing. An imbalance in hormones can make your blood sugar go too low or high, impacting your energy levels and heart rate. While rare, a neuroendocrine tumor can also impact the function of your heart valves.
Tests for Neuroendocrine Tumors
Tests Overview
Several tests may be performed to accurately diagnose or confirm neuroendocrine tumors. If you have been referred to Duke, you may already have results from biopsies, blood tests, or scans. We’ll use these to guide your care and may run additional tests to develop your personalized treatment plan.
Blood and Urine Tests
Description
These tests indicate the level of proteins or hormones in your body made by neuroendocrine tumors. Your provider will use the results to confirm the presence of tumors and determine how fast a neuroendocrine tumor may grow or spread.
Advanced Imaging
Description
CT scans and MRI can help identify a tumor’s location and size.
Advanced PET Scan
Description
PET scans detect neuroendocrine tumors based on how the tumors interact with medically safe radioactive drugs. For slow-growing neuroendocrine tumors, you may have an injection of a drug called DOTATATE that helps your doctor see neuroendocrine cells on a PET scan. For fast-growing tumors, you may have a specialized PET scan that uses radioactive sugar molecules to identify cancer cells.
Upper Endoscopy
Description
During an upper endoscopy, a gastroenterologist inserts a small tube with a camera at its tip through your mouth to view your stomach and upper GI tract. Your doctor will look for tumor growth and may take a small tissue sample for examination to determine if cancer is present.
Colonoscopy
Description
During a colonoscopy, a small tube with a camera at its tip is inserted through your rectum to examine the colon and/or your small intestine. A small tissue sample may be removed and examined to determine if cancer is present.
Echocardiogram
Description
If a neuroendocrine tumor is producing hormones that could lead to of heart valve damage, an ultrasound of the heart may be performed to look for damage.
Treatments for Neuroendocrine Tumors
Treatments Overview
Along with removing a tumor and trying to reduce any spread of cancer, oncologists and endocrinologists will work together to minimize changes in hormone levels that can cause stomach problems and flushing of your skin. If your tumor has metastasized, we have options for treatment.
Active Surveillance and Medication
Description
If you have a slow-growing tumor that is not negatively impacting your health or quality of life, active surveillance may allow you to avoid or postpone surgery or other treatments. Medication may be prescribed to minimize side effects like diarrhea or blood sugar changes. Regular appointments will allow our specialists to actively monitor your health for changes that may require further treatment.
Hormone Therapy
Description
Most people with neuroendocrine tumors receive hormone therapy via a monthly injection to reduce symptoms caused by hormonal imbalances. Hormone therapy may also help shrink the tumor.
Targeted Therapies
Description
If your neuroendocrine tumor is cancerous, it may require certain kinds of proteins to grow. We can prescribe oral medication that can block those proteins and slow or stop growth.
Chemotherapy
Description
Chemotherapy may be prescribed to kill cancer cells and stop them from growing. Your oncologist will determine whether chemotherapy is a good option to include in your treatment plan.
Surgery
Description
Duke surgical oncologists specialize in the removal of neuroendocrine tumors and metastatic cancer. If surgery is an option for you, we'll work to remove as much of your tumor and additional tissue around your tumor as possible, which can help minimize spread. Sometimes surgery will be performed in coordination with other treatments to ensure we remove as much of the tumor as possible.
Image-Guided Ablative Therapies
Description
Radiofrequency ablation (RFA), microwave ablation, and cryoablation are minimally invasive techniques that use extreme heat or cold to kill cancer cells. These procedures use a long, thin probe inserted through your skin. Transarterial embolization (TAE), transarterial chemoembolization (TACE), and transarterial radioembolization (TARE) use a catheter inserted into artery through your groin or wrist to deliver small beads to your tumor. The beads kill cancer cells by blocking blood flow to the tumor or by delivering chemotherapy or radioactive particles into the tumor.
Peptide Receptor Radionuclide Therapy
Description
Intravenous drugs deliver radioactive particles to your tumor to slow or stop growth. Treatment consists of four doses of a radioactive drug every eight weeks.
